by Sarah Myers

“Your therapist thought you were trying to dupe him into thinking you were psychotic.”

 

My disabilities lawyer said this to me minutes before our meeting with the judge. The meeting was to determine whether or not I qualified for welfare for being disabled due to my clinical diagnoses of Schizoaffective Disorder and Posttraumatic Stress Disorder. 

 

“He said you clearly could not be truly psychotic if you still were connected to reality,” he continued. 

 

This was a peculiar comment. Of all of the 10+ therapists in my twelve years of clinical psychiatric care, this was the first and only comment that suggested I was a pathological liar, instead of a genuine psychotic person with the gift of being able to tell the difference between psychotic and nonpsychotic states. 

 

A common misconception of schizophrenia and the psychosis spectrum is that the afflicted individuals remain delusional most, if not 100% of the time, and have somehow lost their minds so much that to even reflect on their experiences would make them lose touch with their psychotic states. 

 

This is not true. Delusions, or unsubstantiated beliefs, and specifically in the psychotic case, the unwarranted, uncontrollable experience of being in a delusional state of mind is not a misplacement of memory. After the delusional episode occurs, one can reflect on their seemingly inconclusive beliefs about the world, such as in the way Elyn Saks in her memoir, The Center Cannot Hold, shares her shame about her speaking with aliens, and such in the way Esme Weijun Wang, in The Collected Schizophrenias, can describe her experience with Capgras Delusion—the belief that your loved one has been replaced by an imposter. 

 

So who is being deluded in this situation? Was it myself in attempting to convince a rather stoic, unimpressed therapist that I had a psychotic disorder, or was it the unimpressed therapist himself? In many cases, having delusions does not mean that one is in the mental state of being delusional. Having a delusion does not necessarily mean that you are in the cognitive state of being delusional. Having delusions in the psychotic sense is a very experiential phenomenon, as if all of a sudden the sky were to turn orange before your eyes. If this were to happen to you, you’d likely try to convince everyone around you that the sky was truly orange. 

 

Since there are no sensory stimuli or input from delusions, it is difficult to explain the state of the mind. But we all share sensory information. We do not share delusions. 

 

I can only speak for myself, but as I experience it, the mental faculties for asserting facts as facts are suddenly switched. Usually the mental faculties for sensory input is the evidence of the senses. E.g. The sky is blue. The fact is that it is blue. This can be confirmed by you, me, and third parties. 

 

In delusions, there are no sensory inputs. The experience of having a psychotic delusion starts at the place of being convinced that something simply just is. The state of mind does not rely on any data to make this conclusion (hence why it is a delusion). The same can be said for any spectrum of delusions. Atheists could make the argument that monotheistic or polytheistic religious followers are delusional, for they have no sensory evidence to properly convince others that there is a God, or Gods. 

 

In psychotic delusions, the belief is especially individualized and unique to the afflicted person. Sure, perhaps the delusion that “I am Jesus” is a common one shared by many, but the sheer number of individuals who bear this psychotic belief contradicts the possibility that it is a casualty of a delusion, as with religious delusions may be, according to atheists. So the two are very different. 

 

Stages

 

My delusions start as a creeping, trickling creek into my consciousness, trickling down as seeds planted in the jelly of my mind over minutes or days, forming the precursors to a full-blown belief. When I become delusional, I recurringly believe that (1) I am Jesus. (2) I am all knowing and can tell the future. (3) I am somehow special (mostly I associate myself to Leonardo da Vinci or some great popularized genius figure of human history). My ego becomes inflated. 

 

On my medications, if I miss a dose, this seed-planting can occur within the hour of a missed 12 hour dosage period. If I am off my medications, the delusional state is always around, waning and waxing by the ebbs and tides of other mental faculties. Perhaps my hallucinations are stronger than my delusional state. I do not experience the personification of delusions through my sensory hallucinations. They remain separate. 

 

Then the delusion seeds begin to grow. I start to be pulled in certain directions. If I am at a bookstore, my delusion will call me to a book that will offer evidence for my delusion before I even know it. It is only later that I realize that it had been creeping up on me all along. 

 

I have the sprouting seeds, and now I am gathering the material in which to boast this argument upon. If I am God, I will pick up outrageous books like the Knights Templar or books on the Illuminati, or conspiracy theories that are outside of the mainstream so as to back up my equally outcast idea that I am the Second Coming of Christ. 

 

Once I have the material to back up my belief, the seeds germinate. It takes over the field of my brain. I begin to think this argument out loud in my head. At this point, I have convinced my inner landscape that I am God. There is no doubt. I am just God. My sincere skepticism and doubt is absent--vanished--tucked out of consciousness, rendering that skill useless and leaving me defenseless in the face of a delusional attack. 

 

There is no other way to put it other than I wholeheartedly believe that my thoughts are facts. But they are not just thoughts. I FEEL these beliefs through my whole body. Every tree branch movement, every synchronous eye glance, every action in the natural world points to this belief that I am God. There is no mental filtering for consideration of other possibilities. Whatever the biological mechanisms are for establishing a balance of evidence versus logical conclusion, it is gone. 

 

Many times, at this point schizophrenics have the ability to know not to say these things to others (but usually after many years of convincing others of their delusion before they are written off). In my case, I cared to share with the whole world that I was Jesus. I quickly tell my friends that I can tell the future. Depending on the person, they either consider this as a possibility or reject this notion.

 

When I was an artist, I would tell these delusions out loud. “Maybe I am the Second Coming of Christ,” I would say to my musician friend. “Maybe you were,” he would reply back. “Maybe we all are reincarnations of the divinity.” The delusion is rationalized into the creative and artistic expression or new age spirituality. Nevertheless, it is still harmful for a psychotic person to have their delusions reinforced.

 

People like Esme Wang and at one time, Oliver Saks, as Wang says in her essay collection and Saks describes in Hallucinations, Capgras Delusion is a very specific delusion, acquiring its own name in the process. Other delusions are not so pervasive in multiple individuals that the psychiatry community gives them names. Elyn Saks describes hers as uniquely hers, though some may share them, not enough would fit a diagnosis of an entire different order. Delusions like thinking you’ve killed many people with your own thoughts and having explosions in your brain are some examples. Saks describes her schizophrenic episodes as waking nightmares, although in my case it slightly differs.

 

It is true, that while my hallucinations and delusions cause me to feel terror and stress, sometimes I don’t necessarily think it is the worst thing in the world. When I think I am Jesus, I actually think it’s a great thing! That is, with an ominous feeling in the background. To be burdened with the responsibilities of God is a tiring one, and it also came with the paranoia that my enemy was as powerful as Satan. The delusion incurred an opposite belief--that although I was powerful--I also had enemies that could destroy me. The delusion underminded itself. A therapist once told me that she notice psychotic delusions to “have a kernel of truth behind them.” For me, I have also found this to be true. The delusion has stemmed from a deep-seeded insecurity about my self that has not surfaced enough for me to explore emotionally.  

 

I can be delusional, but that does not mean that I am incapable of reasoning about my delusions after the delusional episode has occurred. In fact, I use a form of skepticism as a form of Cognitive Behavioral Therapy in order to prevent the full delusional state before it explodes, or to hold my rational mind over until I can get my next dose of meds. I can and remain an individual with rational beliefs and sometimes delusional ones in my own special way… but to some extent, don’t we all?